Organization
PETAL CHIROPRACTIC CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIM A PUCKETT D.C. (VICE PRESIDENT)
(601) 545-1481
Entity
Organization
Contact information
Practice address
130 N MAIN ST, PETAL, MS 39465-2345
(601) 545-1481
(601) 545-1449
Mailing address
130 N MAIN ST, PETAL, MS 39465-2345
(601) 545-1481
(601) 545-1449
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
03/14/2007
Last updated
08/22/2020
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